The Truth About Cosmetic Procedures

When someone whispers that they recently had "some work done," right away the questions start: What was it really like? Did it hurt? Where did you get it done? How much did it cost? But even today, in our youth-obsessed world, people are reluctant to talk about the procedures. So when someone starts talking, we listen.

Several members of the Lifestyle staff recently had some sort of cosmetic procedure. Nothing too invasive, but maybe it's something you've been thinking about. Well, here's the dirt. The good, the bad and the painful of cosmetic procedures.

BOTOX ON THE FOREHEAD

Amy Bertrand, 36, Lifestyle editor

Thank you, Dad, for the genetically produced permanent furrow on my brow. I've had it since my early 20s, and it's always been a source of frustration for me.

I tried bangs, but they were actually too hard to keep up, so I thought I'd try Botox. I entered this endeavor with equal mixes of excitement and trepidation. Excitement: I'd finally be rid of those frustrating creases. Trepidation: What if I did like it? It would be expensive to keep up. And though I've generally been against cosmetic surgery, this may be the start of a 180 for me. Maybe I'll become an addict. A Kathy Griffin wannabe.

So after seeing a flier for a spa at my sons' school, I called Dr. Stanley Librach at Beyond the Face Spa in Chesterfield, Mo., last month.

During his consultation with me, I felt both more nervous and more relaxed (is that possible?). He talked with me about my hopes and expectations, and he explained to me what Botox could do for me. We then agreed on the area to treat. I would have liked to have done my whole forehead, including the 11's between my eyes (well, really mine are more like 111's), but cost was a factor, so we decided I'd get the most bang for my buck out of just the main part of the forehead.

An injection of Botox delivers a small amount of botulism toxin into the facial muscles. The toxin blocks the chemical messenger from the nervous system to the muscle, so it can no longer retract. When the muscle relaxes, the skin over it smoothes out and softens, so wrinkles don't look as deep. Librach said that a year ago he would have told me Botox is 100 percent safe, but with recent studies showing that long-term use can cause muscle atrophy, he can no longer make that 100 percent claim. Thus, the fear.

What it was like - The entire procedure lasted maybe a minute. I stood; he stood in front of me. He injected me five times with a tiny insulin needle. The sticks felt like mosquito bites. And I was done. No bruising, no discoloration, no holes in my head.

The results - Librach told me it would take three to four days to see results. On the fourth day, I could see a difference. A week later, I could really see a difference. A couple of creases were still there, but they weren't as deep. I felt confident and beautiful. The results should last at least three months, and Librach says some last as long as eight. And though I can still move my eyebrows up and down, my forehead is mostly immobile.

Would I do it again? - Though I loved the results, I realized that those furrows on my brow are a part of me. They make me who I am, and I think I've decided that I'll keep them. But I reserve the right to change my mind 10 years down the road.

LASER HAIR REMOVAL

Debra D. Bass, 37, fashion editor

There are many ways to remove hair from inconvenient areas, and I have tried everything I can think of at one time or another - waxing, cream depilatories, electrolysis, shaving and threading.

I finally opted for an expensive laser hair removal regime because I vaguely remember hearing good things about the procedure, but I find it odd that I can't remember from whom. I did some research online, and I knew it wasn't a miracle cure, but because I had exhausted every other option and still wasn't satisfied I figured, "Why not?"

However, I wanted to err on the side of caution. Because I'm black with a cocoa complexion, I didn't want to experiment with any visible regions of the body.

I decided on my underarms because it's just such an annoying area for hair growth, and I don't do that Julia Roberts no-shave thing. It's exponentially more annoying because there's always a hair shadow under my arms after I shave because the pigment of my hair is so much darker than the light tan skin of my underarms.

I signed up for a regime of five laser treatments. It was a promotion of buy three, get two free. But in the end, I received six treatments, because it wasn't nearly as effective as I'd hoped, and the technician decided to switch lasers for the final treatment.

Because of my complexion, my practitioner at Face and Body Day Spa in Brentwood, Mo., recommended a diode laser to begin with because it has been FDA-approved for all complexions. The technical explanation is complicated, but this laser has a better chance of distinguishing flesh from hair in darker skin.

When that wasn't satisfactory, we switched to an intense pulsed light (IPL) laser, which has a slower pulse that can target darker hair even if the skin has pigment, but it's typically for lighter complexions with dark hair.

What it was like - The diode laser was quick and painful. It took less than five minutes per underarm. She started by shaving the region and then applied a lubricant to help cool the skin and allow the tip of the laser to glide smoothly. She applied the roughly quarter-inch square laser tip to small regions and pressed a trigger. It felt exactly like you'd imagine the initial burst of sticking your fingernail in an electrical socket. It took about 10 to 15 zaps per underarm. The IPL laser was much less painful, but not painless. It was a sharp sting like a bee, instead of an electric jolt. And it seemed to produce the same results.

Results - I still shave my underarms at the same frequency that I did before my treatments, which ran from September 2006 to August 2007, but it seems like there's less hair there. There are three things you should know: 1. Pain is fleeting. The laser was the kind of pain I remember abstractly, but it doesn't give me nightmares. I also bought a topical lotion that numbed the laser minutely. 2. Lasers only work on hair in the active growth phase, so that means roughly a third or so of your visible hairs at a time. It's generally recommended to have three to six treatments. Treatments can be spaced out from four to eight weeks or more depending on the area, so if you pay up front make sure it's an operation that will be around in a year or so. 3. Nothing is 100 percent permanent according to the American Society of Aesthetic Plastic Surgery. But lasers are said to have the most long-lasting results and in select cases people boast of being hairless in treated areas. However, I asked seven women who tried laser hair removal, including three who sit within shouting distance of my desk, and all seven said that it didn't have satisfying results.

Cost - About $120 to $250 a treatment depending on the area targeted. Package deals of four to six treatments usually offer a better price that can lower costs from $85 to $125 a treatment.

Would I do it again? - Yes. I can't tell if I'm a masochist or an optimist, but if I discovered a newer generation of laser with better results for my complexion, I'd do it. And apparently, I'm not alone, the ASAPS reports that laser hair removal is the second most popular nonsurgical cosmetic procedure responsible for 1.28 million appointments in 2008.

VASER LIPO

Cherice Jones, 21, Lifestyle intern

I am a naturally curvy woman, and all the exercise in the world couldn't get rid of the fat around my thighs. After trying various diets, exercise and diet pills, I lost weight everywhere but my outer thighs. I decided that I had to find a way to fight what I inherited honestly from my mother. After researching various methods, I decided to get Vaser Lipo on my outer thighs at the Lifestyle Center in Clayton, Mo.

The process was easy, and unlike traditional liposuction, it was very quick. I had to attend two extensive consultations. Dr. Richard Moore and his assistant evaluated my trouble areas, told me about the procedure, set my expectations and showed me dozens of real-life people who had Vaser Lipo done. He explained that it is an outpatient procedure and that I would not have to be put to sleep.

What it was like - On the day of the procedure, I took the medication that Moore prescribed. One pill was an antibiotic to fight possible infections and other was to ease my anxiety.

The nurse gave me undergarments to put on. They took before pictures and did a full body scan. Afterward, I was escorted to the operating room. I was asked to lie on the bed and relax. I received an injection to numb the areas to be treated. From here, Moore cut two slits at the top and bottom of both of my thighs that were no bigger than my pinky nail. He inserted a probe that uses pulse ultrasonic energy at the top of my thigh that liquefies fat. He inserted a tube at the bottom of my thigh that allowed the fat to drain. This entire procedure took about 90 minutes. I didn't feel any pain at this point.

The aftermath of Vaser Lipo is not as glamorous. I bled at the incision points for about four days and had to keep bandages on. Also, I was supposed to wear a not-so-fashionable garment for six weeks. I only wore the garment for two weeks though. I was in excruciating pain for about two weeks. My thighs were huge and swollen. I found that Extra Strength Tylenol and massages on the treated areas really helped. The Vicodin pain pills that they prescribed for me were too strong; I was delusional after taking just one. After two weeks, my swelling subsided, and I was able to return to my normal routines.

Results - It has been about one and a half months since my procedure, and I absolutely love the results. I can tell a difference in the way all of my pants fit. I continue to eat healthy and exercise.

A few things I would suggest for others to consider before they get Vaser Lipo is to really evaluate your body. The procedure will take the fat away, but it is up to you to make your body look different. If you rely solely on the Vaser Lipo, your skin could be loose. You have to tone your body and continue a healthy lifestyle after the procedure to gain desired results. Because I paid almost $2,500 for this procedure, it became my motivation to make the rest of my body look good. I'm obsessed.

Cost - The procedure starts at about $1,995, and there are additional costs for the medication and garments. Your body mass index can also affect the price.

Would I do it again? - Yes, I would definitely do it again. You shouldn't rely only on this to lose weight, but the Vaser Lipo produces great results if you do your part.

PROFACTIONAL LASER PEEL

Aisha Sultan, 35, home and family editor

I am constantly battling my skin. Even though I never really broke out much as a teenager, hormonal changes in my 20s seem to have worsened my occasional acne. A dear friend, who happens to be a dermatologist, told me about the ProFractional laser, which is used to improve the skin's texture and reduce acne scars and discoloration. I knew I wanted to try it in my never-ending quest for clear, smooth, perfect skin.

But having been burned by an IPL laser on my face before, I was wary. Dr. Saadia Raza, with Skin Surgery Center of Missouri in O'Fallon, Mo., told me that she would start at a conservative level. When I went in for the treatment, the assistant cleaned my face and applied a topical numbing cream. After about 20 minutes, the doctor asked if I was ready to get the "blocks." Huh? I had no idea what she was taking about. Apparently, I had to get two shots in between my eyebrows to numb my forehead and four shots in my mouth to numb the cheeks and lower part of my face. Upon learning this, I nearly backed out.

Rather than look like a complete wimp, I closed my eyes, took a deep breath, and told her to go ahead. I refused to look at any kind of needle heading toward my face. The shots hurt. At this point, I was seriously wondering what I had gotten myself into.

After about five to 10 minutes, parts of my face started to go numb, sort of like the Novocain feeling you get at the dentist's office. Usually, the staff tapes your eyes shut to protect them from the laser, but I knew I would not be able to handle the claustrophobic feeling that would invoke. The doctor let me wear special metal eye covers instead.

As the doctor started zapping my face with the laser, an assistant used a suctioning vacuum tube to capture the debris and dissipate the smell of burning flesh. In the parts of my face that were not completely numb, I could feel an intense zap from the laser penetrating my skin. The areas I could feel, like around my upper cheeks and hairline, were like a sharp jolt. There's a reason they suggest those numbing blocks. The doctor decides how deep the laser will penetrate, and how often she passes over the same patch of skin. On me, she said she used a medium-level depth of penetration.

What it was like - It took about 25 minutes for the doctor to complete my entire face. I felt pretty anxious during the procedure and kept giving myself little pep talks in my head: "Visualize clear skin." But the hard part is the week to week-and-a-half of recovery. The first day, my face was very red and bleeding in patches. When I got home, my husband kind of freaked out, and my small children were kind of scared. I felt like a freak, and I couldn't imagine going out in public at that point.

I was given a steroid cream to help reduce any swelling and a lubricating cream to protect the raw skin. I was instructed to apply it twice a day for up to three days. It is important to avoid the sun. I also applied diluted vinegar soaks with cotton washcloths to my face three times a day. That can sting, but it helped in healing the wounds.

Within a day or so of putting all these creams on my face, I woke up with 15 or so whiteheads all over my face. I called the doctor, slightly panicked, and she told me to stop using the ointments, and the pimples would clear up. Eventually, they did.

Within 24 to 48 hours, my skin got dark and brawny and covered in small pixelated "plugs," which look like a little tiny scab in every pore. It looks like you have tire tracks all over your face. My skin felt very tight and dry. This stage can be somewhat disguised by makeup, but it didn't work very well for me, and I didn't want any more gunk on my skin. I went to work with most of those tiny dots visible on my face.

"WHAT HAPPENED TO YOU?" my colleague Karen Deer said, when she passed by. She stopped to get a closer look and had a serious look of concern in her eyes. Fashion editor Debra Bass, who had tried to dissuade me from this treatment in the first place, rolled her eyes and gave me the "I-told-you-so" look.

Within a day, the plugs started falling out. My skin felt pretty gritty through this process, and it lasted several days.

Results - Because I haven't followed the entire recommended series, it's harder to judge the effect. I do see improvement on my old acne scars and overall skin tone, but I think I have to find a way to stop getting new break-outs and prevent potentially new scarring to achieve my dream of completely clear skin.

Cost - To see maximum results, four to five treatments, spaced a month apart, are recommended. Each treatment costs about $500 for the full face.

Would I do it again? - Most likely, but I'll probably do it when I can hide out at home for the first few days post-treatment. I wonder if my doctor would give me a Valium the day of the procedure to calm my nerves. I'm tempted to try my neck and chest area, which has a more uneven skin tone and discoloration than my face. But, as Raza has ingrained into my psyche, you must be vigilant about always using sunscreen.